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What is refractory convulsive status epilepticus?
Refractory status epilepticus (RSE) is a life-threatening disease in children wherein the patient’s convulsive seizures do not respond to adequate initial anticonvulsants. RSE is associated with high rate of mortality and morbidity.
What is benzodiazepine refractory status epilepticus?
Refractory status epilepticus (RSE) is defined as status epilepticus that continues despite treatment with benzodiazepines and one antiepileptic drug. RSE should be treated promptly to prevent morbidity and mortality; however, scarce evidence is available to support the choice of specific treatments.
What drug is used for status epilepticus?
The benzodiazepines are some of the most effective drugs in the treatment of acute seizures and status epilepticus. The benzodiazepines most commonly used to treat status epilepticus are diazepam (Valium), lorazepam (Ativan), and midazolam (Versed).
What is refractory focal epilepsy?
Some people with epilepsy will have, or will one day develop, refractory epilepsy. This means that medicines don’t work well, or at all, to control the seizures. If you have refractory epilepsy, the type of seizures you have may affect your treatment. Seizures may be: Primary (generalized) seizures.
Which medication has been effective in treating status epilepticus that is refractory to phenobarbital?
Lorazepam is the most commonly used agent, used at a dose of 0.1 mg/kg given in dose of 2 mg/min to a maximum of 8 mg. Lorazepam was shown to be successful in 64.9% patients as the first line compared to 58.2% success with phenobarbital and 55.8 % with Diazepam plus Phenytoin.
What is the first-line treatment for status epilepticus?
Diazepam. Diazepam is one of the drugs of choice for first-line management of status epilepticus.
Why is thiamine given in status epilepticus?
Thiamine (100 mg) should be given along with the glucose, because glucose infusion increases the risk of Wernicke’s encephalopathy in susceptible patients. After administration of oxygen, blood gas levels should be determined to ensure adequate oxygenation.
What is the drug most used for status epilepticus?
Early status epilepticus: first-line treatment The first-line treatment for early SE mainly comprises the administration of benzodiazepines, the most frequently used of which include diazepam, lorazepam, and midazolam.
What is refractory status epilepticus (SE)?
Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs) and 15% continue to have seizure activity despite use of three drugs.
What is the role of electroencephalography (EEG) in the treatment of epilepsy?
Electroencephalography monitoring is essential to monitor treatment response in refractory/super-refractory status epilepticus, and to diagnose non-convulsive status epilepticus. The mainstay of treatment for these disorders includes anesthetic infusions, primarily midazolam, ketamine, and pentobarbital.
What is status epilepticus (SE)?
Status epilepticus (SE) has traditionally been defined as more than 30 minutes of continuous seizure activity or two or more sequential seizures without full recovery of consciousness in between for a total of more than 30 minutes.[1]
Which medications are used to treat status epilepticus (SE)?
In hospitalized patients with status epilepticus, intravenous lorazepam is the drug of choice for initial emergency therapy.